Long Term Services and Supports

Many individuals with long-term services and supports (LTSS) needs either reside in institutions or are at risk for institutionalization. Rebalancing care to provide LTSS in the community is one goal of the federal Financial Alignment Initiative for Medicare-Medicaid enrollees. This profile details the experiences of the Health Plan of San Mateo (HPSM) as it implements a pilot program to help dually eligible individuals in nursing facilities transition back to community living.

Hospital readmissions are a large source of wasteful healthcare spending, and current care transition models are too expensive to be sustainable. One way to circumvent cost-prohibitive care transition programs is complement nurse-staffed care transition programs with those staffed by less expensive nonmedical workers. A major barrier to utilizing nonmedical workers is determining the appropriate time to escalate care to a clinician with a wider scope of practice.

This report presents the most current descriptive national information on the supply, organizational characteristics, staffing, and services offered by paid, regulated providers of long-term care services in five sectors; and the demographic, health, and functional composition of users of these services. Services users include residents of nursing homes and residential care communities, patients of home health agencies and hospices, and participants of adult day services centers.

The Long-Term Care Financing Collaborative released a final report detailing the consensus framework for long-term care financing reform. LTCFC offered recommendations for reforms to expand access to long-term services and supports (LTSS) for individuals with all financial backgrounds. The proposed changes include: Clear private and public roles for long-term care financing; a new universal catastrophic long-term care insurance program; and redefining Medicaid LTSS to empower greater autonomy.

The Bipartisan Policy Center (BPC), with funding from the SCAN Foundation, published a report offering recommendations to improve the financing of long-term care. The BPC published another report in April 2014 that examined the challenges in financing and delivery. This report is a follow up of those findings that offers recommendations to improve these issues.

This white paper examines the progress that is being made in the Aging Network. This paper covers key developments that are re-shaping the network as well as efforts to better measure the quality and value of its programs and services. The paper also includes: Case studies highlighting the work of the aging network in Florida, Massachusetts and California, discussion of quality initiatives and congressional actions, and concluding observations.

The Center for Health Care Strategies (CHCS), in partnership with Mathematica Policy Research and Airam Actuarial Consulting, released an issue brief on the state considerations when setting capitation rates for Medicaid Managed Long-Term Services and Supports (MLTSS) programs. CHCS and its partners examined the considerations taken by eight states (Arizona, Kansas, Massachusetts, Minnesota, Tennessee, Texas, Virginia, and Wisconsin) as they established their MLTSS rates.

The AARP Public Policy Institute published a report that examined what state Medicaid agencies need in order to effectively monitor the performance of managed long-term services and supports (MLTSS) programs. Eight states with long-term experience operating and overseeing MLTSS were used to analyze monitoring capacities and develop promising practices. The states were: Arizona, Massachusetts, Minnesota, New Mexico, New York, Tennessee, Texas and Wisconsin.

The results of the annual survey represent a snapshot of the current status of state government employees, the agencies that administer the programs, and the services that are provided. The 2015 survey revealed that states are continuing to address the same underlying challenges discussed in the previous reports.The report also includes summary tables that outline specific information about each individual state agency and LTSS program. Email adiaz@advancingstates.org to request a hard copy version.

The Associated Press-NORC Center for Public Affairs Research conducted a study to examine the policy issue of long term care and its financing. This research investigated the awareness, attitudes, and understanding of long term care by Americans over the age of 40 through three different studies. The studies have explored diverse issues surrounding long term care like the caregiving experience, person-centered care experiences, and opinions on long term care policy.